Organization
AFFILIATES IN COUNSELING LLC
Active
Other names
The Center For Divorce Recovery
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MORTON C MIRMAN PH.D. (PARTNER)
(847) 480-0300
Entity
Organization
Contact information
Practice address
633 SKOKIE BLVD, 260, NORTHBROOK, IL 60062-2858
(847) 480-0300
(847) 291-0576
Mailing address
910 SKOKIE BLVD, 215, NORTHBROOK, IL 60062-4013
(847) 480-0300
(847) 291-0576
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
—
—
1041C0700X
Clinical Social Worker
—
—
106H00000X
Marriage & Family Therapist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1620796
BCBS OF IL
IL
Enumeration date
05/16/2006
Last updated
04/27/2011
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